Basic Information
| Provider Information | |||||||||
| NPI: | 1598031858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLAMMER | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | MARK | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 144 SOUTH 500 EAST, SECOND FLOOR | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841021907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014637415 | ||||||||
| FaxNumber: | 8014637341 | ||||||||
| Practice Location | |||||||||
| Address1: | 144 S 500 E FL 2 | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841021907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014637415 | ||||||||
| FaxNumber: | 8014637341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2012 | ||||||||
| LastUpdateDate: | 07/07/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 20A11942 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 8935532-1204 | UT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.